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Resumo O objetivo deste estudo foi descrever a prevalência de idosos com uma ingestão adequada de água e seus fatores associados. Estudo transversal de base populacional realizado em 2014 com idosos (≥ 60 anos) participantes do estudo “COMO VAI?”. Investigou-se o número de copos de água ingeridos/dia pelos entrevistados, considerando-se adequada a ingestão de pelo menos oito copos/dia. As variáveis independentes foram características sociodemográficas, comportamentais e de saúde. A regressão de Poisson foi utilizada para a investigação das associações. Foram entrevistados 1.451 idosos, sendo observado que uma baixa percentagem, 12,6% (IC95% 10,8; 14,7) referiu consumo adequado de água. Maior percentagem de consumo adequado de água foi observada nos idosos mais jovens, com excesso de peso, que apresentaram cinco ou mais doenças e que eram mais dependentes quanto à capacidade funcional. A tendência decrescente de ingestão de água em relação à idade torna essencial o desenvolvimento de ações voltadas para essa população de maior risco acerca da importância de uma ingestão hídrica adequada e das possíveis consequências do seu consumo inadequado.

Abstract The scope of this study was to determine the percentage of elderly individuals receiving an adequate water intake and associated factors among non-institutionalized elderly individuals in the urban area of Pelotas, Rio Grande do Sul. It involved a cross-sectional, population-based study carried out in 2014 with elderly participants (≥ 60 years) of the “COMO VAI?” survey. The amount of water ingested per day of the interviewees was investigated, considering the intake of at least eight glasses per day to be adequate. The independent variables were sociodemographic, behavioral, and health characteristics, and Poisson Regression was used to investigate associations. A total of 1,451 elderly people were interviewed, with only 12.6% (95%CI 10.8; 14.7) drinking a sufficient amount. A higher percentage of the elderly with adequate water consumption was observed in younger elderly individuals, those overweight, those with five or more diseases, and those who were more impaired. A low percentage of the elderly with an adequate water intake was observed among the elderly adults in the study. The decreasing trend of water intake in relation to age highlights the importance of developing actions for the higher risk population to stress adequate water intake and the possible consequences of the lack of adequate consumption.

https://doi.org/10.1590/1413-81232023287.14692022

Prevalência de ingestão hídrica e fatores associados entre idosos não institucionalizados do Sul do Brasil
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Souza, Carolina Corrêa de

; Fernandes, Mayra Pacheco

; Bertoldi, Andréa Dâmaso

; Demarco, Flávio Fernando

; Gonzalez, Maria Cristina

; Bielemann, Renata Moraes

Ciência & Saúde Coletiva

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jul 2023, Volume 28 N. 7 Pages 1903 - 1914

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1413-81232023287.14692022

Dificuldades no uso de medicamentos por idosos acompanhados em uma coorte do Sul do Brasil
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Guttier, Marília Cruz

; Silveira, Marysabel Pinto Telis

; Tavares, Noemia Urruth Leão

; Krause, Matheus Carrett

; Bielemann, Renata Moraes

; Gonzalez, Maria Cristina

; Tomasi, Elaine

; Demarco, Flavio Fernando

; Bertoldi, Andréa Dâmaso

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230020

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Este estudo visou avaliar a necessidade de ajuda dos idosos para tomar seus medicamentos, bem como as dificuldades relacionadas com a sua utilização, e a frequência de esquecimento de doses. Ainda, avaliar fatores associados à necessidade de ajuda dos idosos com os medicamentos. Métodos: Corte transversal em uma coorte de idosos (60 anos ou mais — estudo “COMO VAI?”), em que foi avaliada a necessidade de ajuda para tomar medicamentos de forma adequada e as dificuldades apresentadas na sua utilização. Utilizou-se regressão de Poisson para estimar as razões de prevalência (RP) brutas e ajustadas dos desfechos e seus intervalos de confiança de 95% (IC95%) de acordo com as características da amostra. Resultados: Participaram 1.161 idosos. A prevalência de idosos que relataram necessidade de ajuda com os medicamentos foi de 15,5% (IC95% 13,5–17,8), sendo que os mais idosos, com menor escolaridade e em pior situação econômica, em uso de quatro medicamentos ou mais e com pior autoavaliação de saúde foram os que mais necessitaram de ajuda. O uso contínuo de medicamentos foi referido por 83,0% (IC95% 80,7–85,1) e a maioria (74,9%; IC95% 72,0–77,5) nunca se esqueceu de tomar seus medicamentos. Conclusão: Observou-se a influência de determinantes sociais e econômicos e de saúde sobre a necessidade de ajuda para a utilização dos medicamentos. Estudos que estimem as dificuldades no uso de medicamentos por idosos são importantes para subsidiar políticas e práticas norteadoras de ações para melhorar a adesão e o uso racional de medicamentos.

ABSTRACT Objective: This study aimed to assess the need for help by elderly people to take their medications, the difficulties related to this activity, the frequency of forgotten doses, and factors associated. Methods: Cross-sectional study conducted with a cohort of elderly people (60 years and over — “COMO VAI?” [How do you do?] study), where the need for help to properly take medication and the difficulties faced in using them were evaluated. The Poisson regression model was used to estimate the crude and adjusted prevalence ratios (PR) of the outcomes and respective 95% confidence intervals according to the characteristics of the sample. Results: In total, 1,161 elderly people were followed up. The prevalence of participants who reported requiring help with medication was 15.5% (95%CI 13.5–17.8), and the oldest subjects, with lower educational levels, in worse economic situations, on four or more medications and in bad self-rated health were the ones who needed help the most. Continuous use of medication was reported by 83.0% (95%CI 80.7–85.1) of the sample and most participants (74.9%; 95%CI 72.0–77.5) never forgot to take their medications. Conclusion: The need for help to use medications was shown to be influenced by social and economic determinants. Studies assessing the difficulties in medication use by the elderly are important to support policies and practices to improve adherence to treatment and the rational use of medications.

https://doi.org/10.1590/1980-549720230020.2

Dificuldades no uso de medicamentos por idosos acompanhados em uma coorte do Sul do Brasil
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Guttier, Marília Cruz

; Silveira, Marysabel Pinto Telis

; Tavares, Noemia Urruth Leão

; Krause, Matheus Carrett

; Bielemann, Renata Moraes

; Gonzalez, Maria Cristina

; Tomasi, Elaine

; Demarco, Flavio Fernando

; Bertoldi, Andréa Dâmaso

Revista Brasileira de Epidemiologia

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2023, Volume 26 elocation e230020

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1980-549720230020.2

Mapping of SARS-CoV-2 in Waldeyer’s lymphatic ring and visceral biopsies: the age and the illness duration’s impact
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Alba, Jose Ramón

; Zapater, Enrique

; Martin, Cristina

; Ocete, Dolores

; Gonzalez-Cruz, Alfonso

; Angel-de-Miguel, Angel

; Ferrer, Carolina

; Oishi, Natsuki

Brazilian Journal of Otorhinolaryngology

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2023, Volume 89 N. 6 elocation 101317

Abstract: En | Text: En | PDF: En

Abstract Objective: To study the impact of age and the interval between disease diagnosis and death on the organotropism of SARS-CoV-2. Method: Patients underwent post-mortem biopsies from lungs, Waldeyer ring, heart, liver, kidneys and bone marrow between 2020–2021. SARS-CoV-2 organotropism was mapped by using molecular RT-PCR analyses for SARS-CoV2 targeting the Envelope gene (E), the RNA Polymerase Gene (RdRp), and the Nucleocapsid gene (N). Statistical and linear regression analysis was performed to study the impact of age and illness duration in SARS-CoV-2 organotropism. Results: We performed 158 postmortem biopsies in 21 patients, with a mean age of 76 years old. The mean interval between the diagnosis of the infection to the death was 23 days. The RNA of the SARS-CoV-2 was detected in 100% of lung biopsies, 76%–82% of Waldeyer’s ring biopsies, 55% of heart biopsies, 40% of kidney biopsies, 33% of liver and 25% of bone marrow biopsies. Patients who died before the day 9, presented extensive visceral dissemination of SARS-CoV-2 RNA. Most of the patients older than 80 years (90%) presented visceral dissemination of SARS-CoV-2 RNA, while among younger patients, only 3/11 patients presented visceral dissemination of the virus. The relationship between “age” and “illness duration” and multitropism of the virus was statistically significant (p< 0.001). Conclusion: Disease interval and age were factors that were significantly associated with RT-PCR positive results in multiple organs. Critical COVID-19 patients have multiorganic viral dissemination in early stages. In the critical older patients, multiorganic viral dissemination is the rule. Level of evidence: 4. Case Series.

https://doi.org/10.1016/j.bjorl.2023.101317

New species of Polystomoides (Monogenoidea: Polystomatidae) parasitizing the urinary bladder of a freshwater turtle in Brazil Monogenoidea (Monogenoidea Polystomatidae
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Lignon, Julia Somavilla

; Cohen, Simone Chinicz

; Justo, Marcia Cristina Nascimento

; Du Preez, Louis

; Comarella, Carine Glaucia

; Nishimaru, Rogerio Akio

; Souza, Paulo Vinicius Abbade Moreira

; Ataíde, Michelli Westphal de

; Müller, Daniel Curvellho de Mendonça

; Brun, Maurício Veloso

; Monteiro, Silvia Gonzalez

Revista Brasileira de Parasitologia Veterinária

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2023, Volume 32 N. 3 elocation e007823

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Trachemys dorbigni é a espécie de tartaruga de água doce mais abundante do Rio Grande do Sul, no Sul do Brasil. Sabe-se que os quelônios são hospedeiros de uma grande variedade de patógenos, incluindo vírus, bactérias, hemoparasitos e helmintos. Dentre estes, oito gêneros de Polystomatidae (Platyhelminthes: Monogenoidea) infectam tartarugas de água doce: Apaloneotrema, Aussietrema, Fornixtrema, Manotrema, Pleurodirotrema, Polystomoidella, Polystomoides, Uropolystomoides e Uteropolystomoides. No entanto, pouco ainda se sabe sobre a biologia destes parasitos na Região Neotropical. Durante uma citoscopia investigativa, foram observados espécimes de Polystomatidae localizados no interior da bexiga urinária de T. dorbigni. Os espécimes coletados foram fixados e corados para identificação taxonômica. No presente artigo, uma nova espécie de Polystomoides (Monogenoidea: Polystomatidae) parasitando a bexiga urinária de tartaruga de água doce da espécie T. dorbigni no Brasil é descrita. Polystomoides santamariensis n. sp. difere das demais espécies no tamanho dos espinhos genitais, que são maiores. Devido a enorme diversidade de tartarugas de água doce ao redor do mundo, é provável que um grande número de polistomatídeos de quelônios ainda seja desconhecido. Sabese Sabe patógenos vírus bactérias helmintos estes Platyhelminthes (Platyhelminthes Monogenoidea Apaloneotrema Aussietrema Fornixtrema Manotrema Pleurodirotrema Polystomoidella Uteropolystomoides entanto Neotropical investigativa T taxonômica artigo (Monogenoidea descrita n sp genitais maiores mundo desconhecido

Abstract Trachemys dorbigni is the most abundant freshwater turtle species in Rio Grande do Sul, southern Brazil. Chelonians are known to host a wide variety of pathogens, including viruses, bacteria, hemoparasites and helminths. Among these, nine genera of polystomatid flatworms (Monogenoidea; Polystomatidae) infect freshwater turtles: Apaloneotrema, Aussietrema, Fornixtrema, Manotrema, Pleurodirotrema, Polystomoidella, Polystomoides, Uropolystomoides and Uteropolystomoides. However, little is known about the biology of these parasites in the Neotropical Realm. Through investigative cystoscopy, specimens of Polystomatidae were located inside the urinary bladder of the host T. dorbigni. Retrieved specimens were fixed and stained whole mounts prepared for taxonomic identification. In the present paper, a new species of Polystomoides (Monogenoidea: Polystomatidae) parasitizing the urinary bladder of a freshwater turtle of the species T. dorbigni in Brazil is described. Polystomoides santamariensis n. sp. differs from the congeneric species on the length of the genital spines, which are longer. Given the enormous diversity of freshwater turtles around the world, it is likely that a large number of chelonian polystomatids are still unknown. Sul pathogens viruses bacteria helminths Monogenoidea (Monogenoidea Apaloneotrema Aussietrema Fornixtrema Manotrema Pleurodirotrema Polystomoidella Uteropolystomoides However Realm cystoscopy T identification paper described n sp spines longer world unknown

https://doi.org/10.1590/s1984-29612023045

Coronary Artery Disease in Women: Getting to Know Gender Related Disparities Women
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Gilabert-Garcia, Ana

; Guerrero, Cristina Cristina Villarreal

; Dagio-Cuéllar, Rodrigo

; Bermudez-Gonzalez, Jorge Luis

; Perez-Partida, Arantza Marie

; Berarducci, Joaquin

; Armenta-Moreno, Javier Ivan

; Luna-Alvarez-Amezquita, Jose

; Straface, Juan Ignacio

; Espinola-Zavaleta, Nilda

; Alexanderson, Erick

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220022

Abstract: En | Text: En | PDF: En

Abstract Coronary artery disease (CAD) and ischemic heart disease (IHD) are often indistinctly used terms. Both combined have generated, over the past years, concerns about sex disparities in their presentation. From an epidemiological perspective, females have several disadvantages regarding the prevention, diagnosis, and treatment of CAD. Most of the general cardiovascular risk factors affect women more frequently, or with a higher morbidity and mortality association. Besides, atypical manifestations of the disease and uncommon forms of CAD represent a diagnostic challenge for clinicians. Even if current treatments for CAD have no apparent sex bias, women representation in clinical trials and treatment patterns analyzed in clinical practice refuse this statement. Several disparities are caused by inevitable sex-particularities, but many of them are more social, cultural, and dogmatic beliefs that have to be addressed and overhaul. (CAD IHD (IHD terms generated years presentation perspective prevention diagnosis frequently association Besides clinicians bias statement sexparticularities, sexparticularities particularities, particularities sex-particularities social cultural overhaul

https://doi.org/10.36660/ijcs.20220022

Acute kidney injury outcomes in covid-19 patients: systematic review and meta-analysis
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Silva, Beatriz Moreira

; Assis, Letícia Cristina Silva De

; Batista Júnior, Maurício De Castro

; Gonzalez, Naara Affonso Philipps

; Anjos, Samuel Benni Dos

; Goes, Miguel Angelo

Brazilian Journal of Nephrology

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dec 2022, Volume 44 N. 4 Pages 543 - 556

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background: Acute kidney injury (AKI) is a frequent complication of coronavirus-19 disease (COVID-19). Therefore, we decided to perform a systematic review and meta-analysis with data from the literature to relate the development of COVID-19 associated-AKI with comorbidities, medications, and the impact of mechanical ventilation. Methods: We performed a systematic review using the Newcastle-Ottawa scale and a meta-analysis using the R program. Relevant studies were searched in the PubMed, Medline, and SciELO electronic databases. Search filters were used to include reports after 2020 and cohort studies. Results: In total, 1166 articles were identified and 55 English-written articles were included based on the risk of bias. Of all COVID-19-hospitalized patients presenting with AKI (n = 18029) classified as Kidney Disease Improving Global Outcomes stage 1 to 3, approximately 18% required mechanical ventilation and 39.2 % died. Around 11.3% of the patients required kidney replacement therapy (KRT) and of these, 1093 died and 321 required continuous KRT. Death is more frequent in individuals with AKI [OR 6.03, 95%CI: 5.73-6.74; p<0.01]. Finally, mechanical ventilation is an aggravating factor in the clinical conditions studied [OR 11.01, 95%CI: 10.29-11.77; p<0.01]. Conclusion: Current literature indicates AKI as an important complication in COVID-19. In this context, we observed that comorbidities, such as chronic kidney disease and heart failure, were more related to the development of AKI. In addition, mechanical ventilation was seen as an aggravating factor in this scenario.

Resumo Antecedentes: Lesão renal aguda (LRA) é uma complicação frequente da doença do coronavírus-19 (COVID-19). Desta forma, decidimos realizar uma revisão sistemática e uma metanálise com dados da literatura para relacionar o desenvolvimento de LRA associada à COVID-19 com comorbidades, medicamentos e o impacto da ventilação mecânica. Métodos: Realizamos uma revisão sistemática usando a escala de Newcastle-Ottawa e uma metanálise utilizando o programa R. Estudos relevantes foram pesquisados nos bancos de dados eletrônicos PubMed, Medline e SciELO. Foram utilizados filtros de pesquisa para incluir relatos após 2020 e estudos de coorte. Resultados: No total, foram identificados 1166 artigos, e foram incluídos 55 artigos escritos em língua inglesa com base no risco de viés. De todos os pacientes hospitalizados por COVID-19 apresentando LRA (n = 18029) classificados como Kidney Disease Improving Global Outcomes estágios 1 a 3, aproximadamente 18% necessitaram de ventilação mecânica e 39,2% foram a óbito. Cerca de 11,3% dos pacientes necessitaram de terapia renal substitutiva (TRS) e destes, 1093 foram a óbito e 321 necessitaram de TRS contínua. O óbito é mais frequente em indivíduos com LRA [OR 6,03; IC95%: 5,73-6,74; p<0,01]. Por fim, a ventilação mecânica é um fator agravante nas condições clínicas estudadas [OR 11,01; IC95%: 10,29-11,77; p<0,01]. Conclusão: A literatura atual indica a LRA como uma complicação importante na COVID-19. Neste contexto, observamos que comorbidades, como doença renal crônica e insuficiência cardíaca, estiveram mais relacionadas ao desenvolvimento de LRA. Além disso, a ventilação mecânica foi vista como um fator agravante neste cenário.

https://doi.org/10.1590/2175-8239-jbn-2022-0013en

Uso de medicamentos com ação anticolinérgica em idosos e comparação entre escalas de risco: estudo de base populacional
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Miranda, Vanessa Iribarrem Avena

; Silveira, Marysabel Pinto Telis

; Lutz, Bárbara Heather

; Pirolli, Flávia

; Zambiasi, Lucas

; Bielemann, Renata M

; Gonzalez, Maria Cristina

; Bertoldi, Andréa Dâmaso

Ciência & Saúde Coletiva

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mar 2022, Volume 27 N. 3 Pages 1087 - 1095

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O padrão de morbimortalidade tem-se modificado nos últimos anos com aumento das doenças crônicas não-transmissíveis levando a múltiplas comorbidades e ao uso de muitos medicamentos. O objetivo foi avaliar o uso de medicamentos com ação anticolinérgica por idosos. Estudo transversal de base populacional, com indivíduos de 60 anos ou mais. Foram investigados fatores socioeconômicos, problemas de saúde e utilização de medicamentos nos últimos 15 dias. Para a classificação dos medicamentos com atividade anticolinérgica foram utilizadas as escalas: Anticholinergic Drug Scale (ADS), Anticholinergic Risc Scale (ARS), Anticolinergic Cognitive Burden Scale (ACB). Entrevistados 1.451 idosos, destes, 1.305 utilizaram medicamentos, sendo que 60,7% usaram fármacos com ação anticolinérgica, sobretudo aqueles com mais de 80 anos e os menos escolarizados. No total, 5.703 medicamentos foram usados, 1.282 (22,5%) com ação anticolinérgica. Observou-se concordância kappa de 0,63 quando se avaliou as escalas de risco ACB e ADS. A prevalência de uso de fármacos com ação anticolinérgica foi alta, deve-se estar atento às consequências relativas ao seu uso, tendo em vista a tomada de decisão mais racional na prática clínica.

Abstract The pattern of morbidity and mortality has changed in recent years due to the increase in chronic noncommunicable diseases, leading to multiple comorbidities and the use of several medications. The scope of the study was to evaluate the anticholinergic drugs used by elderly people, according to risk scales. It involved a population-based cross-sectional study with elderly people. Socioeconomic factors, health problems, and medication use were investigated in the previous 15 days. The Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS) and the Anticholinergic Cognitive Burden Scale (ACB) were used for risk classification according to anticholinergic activity of the drugs. A total of 1451 elderly people were interviewed and 1305 used medications, 60.7% of which with anticholinergic action, especially among the 80-year-old age bracket and the less educated. In total, 5703 drugs were used, 1282 (22.5%) of which with anticholinergic action. Kappa agreement of 0.63 was observed when assessing the ACB and ADS risk scales. The prevalence of the use of drugs with anticholinergic action was high, and attention should be paid to the consequences related to their use, with a view to more rational decision-making in clinical practice.

https://doi.org/10.1590/1413-81232022273.42002020

10.

Un año de docencia online en la educación superior: valoración de docentes y alumnos
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Martín-Sabroso, Cristina

; Alonso Gonzalez, Mario

; Fernández-Carballido, Ana

; Torres-Suárez, Ana Isabel

; Fraguas-Sánchez, Ana Isabel

Revista Iberoamericana de Tecnología en Educación y Educación en Tecnología

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mar 2022, N. 32 Pages 86 - 92

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen La necesidad de transformar la docencia presencial a docencia online debido al COVID-19 supuso un reto para docentes y para alumnos. Lo inesperado de la situación hizo que rápidamente se intentaran establecer estrategias de virtualización que no en todos los casos fueron igual de eficaces. Después de un año de docencia online, es interesante analizar la valoración que tanto docentes como estudiantes realizan a todas estas estrategias y conocer su percepción ante esta situación. En este artículo se recoge la valoración de más de 50 alumnos del grado de Farmacia sobre la docencia online teórica, la docencia online práctica y la evaluación online, destacando las ventajas y limitaciones que suponen estos métodos de enseñanza. También se recoge la valoración de docentes que evalúan de forma positiva todo lo aprendido sobre TICs y nuevas plataformas pero que al igual que los alumnos piensan que el entorno no presencial supone una desventaja para la formación de los alumnos en grados con una importante carga de docencia práctica.

Abstract The COVID -19 pandemic forced to move from face-to-face teaching to completely virtual teaching, which was a great challenge for both teachers and students. The unexpectedness of the situation led to rapid attempts to establish virtualization strategies, which were not always equally effective. After one year of online teaching, it is interesting to analyze the assessment that both teachers and students make of all these strategies and their perception of this situation. This manuscript collects the analysis of more than 50 students of the Pharmacy degree on both, theoretical and practical online lessons and on online exams, highlighting their advantages and limitations. Teacher’s assessment is also included. On the one hand, teachers positively value all that they have learned about information and communication technologies (ICTs) and the developed online teaching platforms. However, they consider that a completely virtual education impairs the learning, especially in practical lessons.

https://doi.org/10.24215/18509959.32.e9

11.

Low molecular weight heparin is useful in adult COVID-19 inpatients. Experience during the first Spanish wave: observational study
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Gonzalez-Porras, Jose Ramon

; Belhassen-Garcia, Moncef

; Lopez-Bernus, Amparo

; Vaquero-Roncero, Luis Mario

; Rodriguez, Beatriz

; Carbonell, Cristina

; Azibeiro, Raul

; Hernandez-Sanchez, Alberto

; Martin-Gonzalez, Jose Ignacio

; Manrique, Juan Miguel

; Alonso-Claudio, Gloria

; Alvarez-Navia, Felipe

; Madruga-Martin, Jose Ignacio

; Macias-Casanova, Ronald Paul

; García-Criado, Jorge

; Lozano, Francisco

; Moyano, Jose Carlos

; Sanchez-Hernandez, Miguel Vicente

; Sagredo-Meneses, Víctor

; Borras, Rafael

; Bastida, Jose María

; Hernández-Pérez, Guillermo

; Chamorro, Antonio Javier

; Marcos, Miguel

; Martin-Oterino, Jose Angel

Sao Paulo Medical Journal

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feb 2022, Volume 140 N. 1 Pages 123 - 133

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: The intensity of the thromboprophylaxis needed as a potential factor for preventing inpatient mortality due to coronavirus disease-19 (COVID-19) remains unclear. OBJECTIVE: To explore the association between anticoagulation intensity and COVID-19 survival. DESIGN AND SETTING: Retrospective observational study in a tertiary-level hospital in Spain. METHODS: Low-molecular-weight heparin (LMWH) status was ascertained based on prescription at admission. To control for immortal time bias, anticoagulant use was analyzed as a time-dependent variable. RESULTS: 690 patients were included (median age, 72 years). LMWH was administered to 615 patients, starting from hospital admission (89.1%). 410 (66.7%) received prophylactic-dose LMWH; 120 (19.5%), therapeutic-dose LMWH; and another 85 (13.8%) who presented respiratory failure, high D-dimer levels (> 3 mg/l) and non-worsening of inflammation markers received prophylaxis of intermediate-dose LMWH. The overall inpatient-mortality rate was 38.5%. The anticoagulant nonuser group presented higher mortality risk than each of the following groups: any LMWH users (HR 2.1; 95% CI: 1.40-3.15); the prophylactic-dose heparin group (HR 2.39; 95% CI, 1.57-3.64); and the users of heparin dose according to biomarkers (HR 6.52; 95% CI, 2.95-14.41). 3.4% of the patients experienced major hemorrhage. 2.8% of the patients developed an episode of thromboembolism. CONCLUSIONS: This observational study showed that LMWH administered at the time of admission was associated with lower mortality among unselected adult COVID-19 inpatients. The magnitude of the benefit may have been greatest for the intermediate-dose subgroup. Randomized controlled trials to assess the benefit of heparin within different therapeutic regimes for COVID-19 patients are required.

https://doi.org/10.1590/1516-3180.2021.0098.r1.08062021

12.

Autonomic dysfunction is common in liver cirrhosis and is associated with cardiac dysfunction and mortality: prospective observational study
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Pimentel, Carolina Frade Magalhães Girardin

; Salvadori, Ricardo

; Feldner, Ana Cristina de Castro Amaral

; Aguiar, Miguel Osman de

; Gonzalez, Adriano Miziara

; Branco, Gabriel Ribas

; Superbia, Marcel

; Lai, Michelle

; Mota, Daniel de Oliveira

; Ferraz, Maria Lucia Cardoso Gomes

; Mathias, Wilson

; Kondo, Mario

Sao Paulo Medical Journal

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feb 2022, Volume 140 N. 1 Pages 71 - 80

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Although autonomic dysfunction has been shown to be associated with liver cirrhosis, the prevalence and prognostic implications are unclear. Abnormal heart rate variability (HRV), a measure of autonomic function, has not been well investigated in cirrhosis. OBJECTIVE: To evaluate the prevalence of high-risk HRV parameters in a cohort of cirrhotic patients and their association with cardiac dysfunction and mortality. DESIGN AND SETTING: Prospective observational study conducted in the Federal University of São Paulo. METHOD: A cohort of 120 patients, comprising 17 healthy controls and 103 cirrhotic outpatients, was evaluated and followed for 10 months. HRV analysis was based on 24-hour Holter monitoring and defined using time-domain and frequency-domain parameters. RESULTS: The HRV parameters were statistically lower in cirrhotic patients than in healthy subjects. High-risk HRV parameters were prevalent, such that 64% had at least one high-risk parameter. Time-domain parameters correlated with Child scores (P < 0.0001). In regression models, HRV parameters were independent predictors of diastolic dysfunction and mortality. During 10 months of follow-up, there were 11 deaths, all of patients with at least one high-risk HRV parameter. Kaplan-Meier analysis estimated low survival rates among patients with standard deviation of normal-to-normal RR intervals (SDNN) < 100. CONCLUSION: Reduced HRV is prevalent in liver cirrhosis and is related to cardiac dysfunction, severity of liver disease and mortality. Abnormal high-risk HRV parameters are prevalent among cirrhotic patients and are also predictors of mortality. Our findings highlight the need for a more careful cardiac evaluation of cirrhotic patients.

https://doi.org/10.1590/1516-3180.2021.0111.r1.18052021

13.

Official position of the Brazilian Association of Bone Assessment and Metabolism (ABRASSO) on the evaluation of body composition by densitometry: part I (technical aspects)— general concepts, indications, acquisition, and analysis
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Maeda, Sergio Setsuo

; Peters, Barbara Santarosa Emo

; Martini, Lígia Araújo

; Antunes, Hannah Karen Moreira

; Gonzalez, Maria Cristina

; Arantes, Henrique Pierotti

; Prado, Carla M.

; Pinto, Camila Lemos

; Araújo, Iana Mizumukai de

; Paula, Francisco José Albuquerque de

; Borges, Joao Lindolfo Cunha

; Albergaria, Ben-Hur

; Ushida, Marcela

; Souza, Guilherme Cardenaz de

; Mendonça, Laura Maria Carvalho de

; Prado, Mirley do

; Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2022, Volume 62 elocation 7

Abstract: En | Text: En | PDF: En

Abstract Objective: To review the technical aspects of body composition assessment by dual-energy X-ray absorptiometry (DXA) and other methods based on the most recent scientific evidence. Materials and methods: This Official Position is a result of efforts by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism (Associação Brasileira de Avaliação Óssea e Osteometabolismo, ABRASSO) and health care professionals with expertise in body composition assessment who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications. In this first part of the Official Position, the authors discuss the different methods and parameters used for body composition assessment, general principles of DXA, and aspects of the acquisition and analysis of DXA scans. Conclusion: Considering aspects of accuracy, precision, cost, duration, and ability to evaluate all three compartments, DXA is considered the gold-standard method for body composition assessment, particularly for the evaluation of fat mass. In order to ensure reliable, adequate, and reproducible DXA reports, great attention is required regarding quality control procedures, preparation, removal of external artifacts, imaging acquisition, and data analysis and interpretation.

https://doi.org/10.1186/s42358-022-00241-8

14.

Uso de medicamentos com ação anticolinérgica em idosos e comparação entre escalas de risco: estudo de base populacional
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Miranda, Vanessa Iribarrem Avena

; Silveira, Marysabel Pinto Telis

; Lutz, Bárbara Heather

; Pirolli, Flávia

; Zambiasi, Lucas

; Bielemann, Renata M

; Gonzalez, Maria Cristina

; Bertoldi, Andréa Dâmaso

Ciência & Saúde Coletiva

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2022, Volume 27 N. 3 Pages 1087 - 1095

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232022273.42002020

15.

Official Position of the Brazilian Association of Bone Assessment and Metabolism (ABRASSO) on the evaluation of body composition by densitometry—part II (clinical aspects): interpretation, reporting, and special situations
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Maeda, Sergio Setsuo

; Albergaria, Ben-Hur

; Szejnfeld, Vera Lúcia

; Lazaretti-Castro, Marise

; Arantes, Henrique Pierotti

; Ushida, Marcela

; Domiciano, Diogo Souza

; Pereira, Rosa Maria Rodrigues

; Marin-Mio, Rosângela Villa

; Oliveira, Mônica Longo de

; Mendonça, Laura Maria Carvalho de

; Prado, Mirley do

; Souza, Guilherme Cardenaz de

; Palchetti, Cecília Zanin

; Sarni, Roseli Oselka Saccardo

; Terreri, Maria Teresa

; Castro, Luiz Claudio Gonçalves de

; Artoni, Silvana Martinez Baraldi

; Amoroso, Lizandra

; Karcher, Débora Emy

; Prado, Carla M.

; Gonzalez, Maria Cristina

; Pinheiro, Marcelo de Medeiros

Advances in Rheumatology

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2022, Volume 62 elocation 11

Abstract: En | Text: En | PDF: En

Abstract Objective: To present an updated and evidence-based guideline for the use of dual-energy x-ray absorptiometry (DXA) to assess body composition in clinical practice. Materials and methods: This Official Position was developed by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism ( Associação Brasileira de Avaliação Óssea e Osteometabolismo , ABRASSO) and experts in the field who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications in the area of body composition assessment. In this second part of the Official Position, the authors discuss the interpretation and reporting of body composition parameters assessed by DXA and the use of DXA for body composition evaluation in special situations, including evaluation of children, persons with HIV, and animals. Conclusion: This document offers recommendations for the use of DXA in body composition evaluation, including indications, interpretation, and applications, to serve as a guiding tool in clinical practice and research for health care professionals in Brazil.

https://doi.org/10.1186/s42358-022-00240-9

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